Keith Lafountain, LMFT | |
58120 Morton St, Marathon, FL 33050-5728 | |
(305) 924-4673 | |
Not Available |
Full Name | Keith Lafountain |
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Gender | Male |
Speciality | Counselor - Mental Health |
Location | 58120 Morton St, Marathon, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1235873233 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | MT3230 (Florida) | Primary |
Entity Name | Change Of Mind Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1811443195 PECOS PAC ID: 4284971672 Enrollment ID: O20190123001743 |
Mailing Address | Practice Location Address |
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Keith Lafountain, LMFT 58120 Morton St, Marathon, FL 33050-5728 Ph: (305) 924-4673 | Keith Lafountain, LMFT 58120 Morton St, Marathon, FL 33050-5728 Ph: (305) 924-4673 |
Sarah Rollo, BS Counselor Medicare: Not Enrolled in Medicare Practice Location: 3000 41st Street Ocean, Marathon, FL 33050 Phone: 305-422-0576 | |
Mr. Trey Ilgen, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3000 41st St., Ocean, Marathon, FL 33050 Phone: 305-434-7660 Fax: 305-434-9040 | |
Deborah S. Matthews, M.S., L.M.H.C Counselor Medicare: Not Enrolled in Medicare Practice Location: 3000 41st Street Ocean, Marathon, FL 33050 Phone: 305-434-9000 Fax: 303-434-9040 | |
Dwayne Kemar Ellis, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3000 41st Street Ocean, Marathon, FL 33050 Phone: 305-433-0576 | |
Ms. Susan Marie Ambrosius X, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 10015 Overseas Hwy, Marathon, FL 33050 Phone: 305-289-2779 | |
Robert Prosser, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3000 41st Street Ocean, Marathon, FL 33050 Phone: 305-434-7660 | |
Mrs. Amanda Elaine Belcher-hollywood, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3000 41st Street Ocean, Marathon, FL 33050 Phone: 305-434-9000 Fax: 305-434-9040 |